More than 142,000 people were taken to emergency departments for opioid overdoses during a recent 15-month period, a dramatic rise and the latest sign that the drug epidemic continues to worsen despite the efforts of public health authorities.

The 142,557 emergency visits in 45 states marked a nearly 30 percent increase between July 2016 and September 2017, the Centers for Disease Control and Prevention announced Tuesday. In 16 states that have suffered high rates of overdose deaths, the jump was even higher, at 34.5 percent. No region or demographic group was spared, and two states - Wisconsin and Delaware - saw overdose visits to their emergency rooms more than double.

The data represent yet another dismal sign that efforts to curb the worst drug epidemic in U.S. history have not taken hold in most of the country. And unlike the annual tally of overdose deaths, which lag by a year, they provide more evidence that the crisis continues to head in the wrong direction. Nearly 64,000 people died of drug overdoses, two-thirds of them from opioids, in 2016.

"The bottom line," said Anne Schuchat, the CDC's acting director, "is that no area of the United States is exempt from this epidemic."

She added that the emergency room data show that "for every fatal case, there are many more nonfatal cases, each one with its own personal and economic toll."

The data also confirmed again that the drug crisis, which started in rural America with the diversion of hundreds of millions of prescription painkillers to the black market, has struck cities hard, probably because of the increase in the use of the street drugs heroin and fentanyl.

The survey did find small declines in overdose visits in a few states, including Massachusetts and New Hampshire. But the drops were considered too small to be significant and may have occurred because those states had very high overdose rates in previous years, Schuchat said.